HomeMy WebLinkAboutPROJECT INFORMATIONI
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A16'r COMOX
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57823336
SCANNED
BY
St. LucierCoul
Plant:
Begin Loading;
Job:
Start Unload:
Finish Unload:
09
Customer Code:
Customer Name;
Ticket Data:
Delivery Address:
I beliv&Y lnstrudqns:
Customer Job Number
Project P.O. Number.
Order Code / Date:
61jer P.O. Numlis'7
W�p 0, - �ge: Map/Rov,]Column;
Dispatcher:
TicketNumbso' I 1 0
3 �,)37't-A�i
Due On Job:
Slump:
Truck Number.
Driver Num her:
Driver No me
End Use:
-. r ...... h,
To I �1`11� .1 C, I
LOAD CUMULATIVE I ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE
QUANTITY QUANTITY QUANTITY
Code:
I Check
a2L-m
Comments:
WATERADDED:
I
Cash Received:
YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE i�ROSSED AT OWNER'SIAGENT'S REQUEST:
IF SIGNATURE
I r1iff,
i.- C] LOAD WAS TESTED BY:
na material. where the customer designates. but the SPECLAILTERMS: Any water added is at customers am Nsk. Itivater is added on job, concrete strength
Company assumes no responsibility for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: , Product may cause skin and/or eye imitation. CAUTION: Material
terms of sale and delivery and accepts concrete as Is. Due to important factors whichr are out of our may be haaardous to your safety arid heafth. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished resulbL No credit for safet� "milling information, and to the maternal safety data sheets for additional information.
returned concrete. Buyers exceptions and calms shall be deemed waived unless made to us in whing AUTHORIZED SIGNATURE'
'W'In one business day after the receipt of materials.
OA
'ERSAL
CUSTOMER
1 9"�'['D N I N -� I
This Delivery Ticket incorporates herein bv reference Buyer's previously executed Credit Application. if any, Seller's Standard,
Terms and Conditions, Seller's Quotatioi iny, and Seller's Order Confirmation (in ng limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agreer ------- ). Seller will provide the Standard Term. -.,d Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type 1P), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gravel, and
other siliceous -materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement andlor fly ash can cause eye irritation, skin and eye burns and allergic skin reactions.
— —Dry� e and.a.-gregate-dust.may cause irritation to eyes, skin, and/or respiratory tract. Dust from handling,
-MILCMt ml I - __ - - -
crushing, grinding, cutti�g_a7nd7or-dfil Fing —may e— silic—osiT-a—nd-efllc7cr-if--inhaled-�
lf ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or bums of the nose. throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with. mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended lin-tits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse th6roughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cQmexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de cr6dito); cualquier
t6rinino estindar, condiciones del vendedor, propuestas del vendedor y orden de confirmaci6n del vendedor (con limitaciones y
,-arantfas), como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveeri Ins t6rminos est�ndares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y quo las cantidades
y materiales fucron entregados come, se expresa en el mismo. Acepta pa.gar el monto de actierdo al contrato; al menos que se identi-
fique con una nota al frente de este documento.
1030
Los productos de agregados son materiales namrales como piedra caliza, dolomita, granite, roca voIcAnica, arena, grava y otros
materiales silicios. Los productos de Co-ment,; tipo Portland. de albaEflerfa, pozzolan (tipo IP). azulejo do
azotea y estuco. Los Lie concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granite, roca volc6nica, arena, grava, y otros materiales sjjicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener mis de 0.025% de silicio cristalino. I
Petigros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irfitaci6n en los ojos, quemaduras en pil-I y ojos, y
reaccibnes al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos. piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, corle y/o perforaci6n puedc contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cAncer si son inhalados. En caso de ser ir-,,eticlos, mantener�c
en tempjeratura c6lida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden cor:tener arnortiazo.
La humedad puede causar ]a liberaci6n del amoniaco. La inhalaci6n del amoniaeo puede causar toser, irritaci61fo,
Seguridad: quemaduras en la nariz, garganta y pulmones. Acudir inmediata,nente al medico. El riesgo e.i la salud depende en'
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto n-r'enongadc, con la piel. Use guantes,protecci6n en los ojos y ropa
Primeros adecuada Para protecci6n. Ldvese las manes conjab6n suave y agua despu6s del manejo de materiales. Evite inhalar
auxilios: polvos. Si se expone, a pelves mds do los limites s ecomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los o�,,)s, inm6diatamente fluya agua en 1 6 parte afectada por 15 minutes.
Si se inhala pblvo. expNgase a aire fresco. Si el cemento fresco tiene coutacto con sus ojos, ldvclos a fondo con
agua. Acuda a atencift m6dica inmediatamente si 1, �rritacift continda.
CEMEX, Memorial Hermann Towrr
929 Gessner, Suit§ 1900
V7 co�nbinado Houston, Texas 77024
02/12 Para mis infonnaci6D visita wiNws:t
7823339
A. Cmmax---)-�
Plant:
Begin Loading:
To Job:
Arrive Job:
StartUnload:
FinishUnload:
Leave Job:
1015-
/0 '10
// VU
I ( /&
Customer Code:
Project Code:
Customer Name:
I - ' !'
Project Name:
Ticket Date: DefiveryAddress:
Delivery Instructions:
f,
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Customs, Job N " urn . bar: Order Cod a / Date:
6,der P.O. Nurn' 'P
Project P.O. Number bar.
Mao Page: Map/RowColumn:
Dispatcher.
TI6 N e I q
191-7 707
Due On Job-
Slump
I
Truck Number:
Driver Number:
Driver Name:
nd Us.
. N 11
1"
r' i 1; 1
17' T r T
Til 71tr0li 11
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LOAD C.UMULATIVE ORDERED MATERIAL CODE PRODUCTION DESCRIPTION UOM UNIT PRICE AMOUNT
QUA TITY UANTITY I QUANTITY
-,f) L-10 E G,
Check
Comments:
Auth Code: I Signature of Driver Receiving
T)J*t-A-'M-A i-F- F
Total COD Order Amount t
Wiffrout Standby Charges:
WATERADDED: GAL YARDS IN DRUM:
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'SIAGENT'S REQUEST:
I
1,( 1 P'l � Y -- - ---- F. I;L I L OPP . --- -- YAR3 �s El LOAD WAS TESTED BY: 10 0 SIGNATURE
Notice: Our drivers will make every effort to place materials where the customer designates, but the SPECIALTERMS: Any water added is at customers own Hskrlf water is added on job, concrete strength
Company assumes no exponsibility, for damages inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin and/or eye infindon. CAUTION: Material
terms of sale and delivery and accepts concrete as Is. Due to important factors which are out of our may be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company wfi not accept any responsibility for the finished results. No credit for safety handling information, and I th roaten.1 safety data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed walved unless made to us in writing AUTHORIZED SIGNATU
within one business day after the receipt of materials. (9)
6BUNIVERSAL ', ' r F- ' � r Pf '� ,, J 0026083 CUSTOMER
!-OnD NUM, : I"
This Delivery Ticket incorporates herein bv reference Buyer's previously executed Credit Application, if any, Seller's Standard
Terms and Conditions, Seller's Quotatioj my, and Seller's Order Confirmation (in mg limitations of warranties), as if futly�'
set forth on this Delivery Ticket ("Agreei--'). Seller will provide the Standard Term- --- I Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
AUUKhUAJLh/ UhIVILIN-L / 4—U1NUKh1LlrKqJMUk— I b/JU.L I A311
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, gravel, and other
0
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite. granite, volcanic rock, sand, gravel, and
0
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards: Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye bums andallergic skin reactions.
�-��—OiYc6ncr�ete�and7Eig.-regaterdust�inayzcause.ArLitaflori-to-e,yes,-skiu--,to,d/or respiratory tract. Dust from handling.
0 li—ca—,�vfiicl��r�a—y —ncer-if;ih1faI6d—.
crushing, grinding, cutting and/or drillin may contain si d-aiTi-i-n—clTa
If ingested, keep warm. at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia, Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or bums of the nose. throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothin-. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
0
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www.cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecuLada en su aplicaci6n de cr6dito); cualquier
tdi-mino estdndar. condiciones del vendedor. propuestas del vendedor y Orden de confirmaci6n del vendedor (con limitaciones y
garantfas). como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los tdrminos estAndares y condiciones detal-
lados en caso de asf ser requeridos. Con este documento, el comprador acepta los mismos ya antes mencionados y que ]as cantidades
y materiales fueron entregados como se expresa on el mismo. Acepta pagar el monto de acuerdo al coDtrato; al menos que se identi-
fique con una nota at frente de este documento.
AGREGADOS / CEMENTO / PRODUCTOS DE CONCRETO /
Los productos do agregados son materiales naturales como piedra caliza, dolomita, granito, roca volc6nica, arena, garlava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albagilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portlandy productos de agregados como piedra caliza, dolon-dta,
granito, roca.volc6nica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) la cual puede
contener m6s do 0.025% do silicio cristalino.
Peligros: MezcIa de cemento fresco y/o cenizas volantes pueden causar irritaci6n en IDS Ojos, quemaduras en piel y Ojos, y
reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los Ojos, piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, coite y/o perforaci6n puede contener materiales
silicos, los cuales; pueden causar silicosis pulmonar y cdncer si SOD inhalados. En caso de ser ingeridos, mantenerse
on temperatura c6lida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden comener amoDiaco.
0
La humedad puede causar la liberaci6n del amoniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o
Seguridad: quemaduras en la nariz, garganta y puLmones. Acudir inmediatamente at medico. El ries.-o en la. salud depende en
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con Ojos y contacto prolongado, con ]a piel. Use guantes, protecci6n en los Ojos y ropa
Primeros adecuada para protecci6n. Ldvese las manos con jab6n suave y agua despu6s del manejo de materiales. Evite iDhalar
auxilios: polvos. Si se expone a polvos mds de los limites recomendados, use protecci6n respiratoria.
Primeros auxilios: ED caso do contacto on los Ojos, inmediatamente fluya agua on In parte afecrada por 15 minutos.
Si se inhala polvo, exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus Ojos, lAvelos a fondo con
agua. Acuda a atenci6n m6dica inmediatamente si la iffitaci6n continda.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
n?/117 Para mds informaci6n visita www.ce
zzc C. M C- X
57823341
Plant:
Begin (oading:
To Job:
Arrive Job:
start unload:
Finish Url
Leave Job:
Return Plarl.
/6", �-�
& -5-1
/ /-�
Customer Code:
3 �naja
a
dco e:
Customer Name:
-I t'-Jng"' V
Project No (a: , , �
Ticket Date: DelleryAddresis
Delivery Instructions:
f
Customer Job Number:
Project P.O. Number:
Order Code I Date:
tc,
(),do, P.O. Nu4e"
M I t�'
a Page: MapiRow/Column:
2—', 2 �- 7,235 u,
Dispatcher:
1 L 0
Ticket Number;
� 8F, i
Due On Job:
Slump
Truck Number:
Driver Number:
Driver Name:
End Use:
B!
-T)Nf'j
t
LOAD
QUANTITY
CUMIJILATIVF I
I QUANTITY
ORDERED
QUANTITY
MATERIAL CODE
PRODUCTIOI� DESCRIPTION
UOM
UNIT PRICE
Cash
Check
I ISKInatureof
r , � 0 "; r c i-;
. — - U
Cash Received:
WATERADDED:
6-7
YARDS IN DRUM:
WHEN ADDED.
Collect
SIGNATURE
CURB LINE CROSSED AT OWNER'SIAGENT'S REQUEST:
DI-IR 1 17 ri 11 1 1 f_Jri.0 "'M F66 0 LOAD WAS TESTED BY: SIGNATURE
Notice: Our drivers will make every efforl! to place materials where the customer designates, but the SPECIALTERMS: Any water added is at customers own risk. lfwater is added on job, concrete strength
Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product May Cause skin and/or eye initatlon. CAUTION: Material
termis of sale and delivery and accepts c:ml as Is. Due to important factors which are out of our my be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results. No credit for safety handlIng information, and to the material safety data sheets for additional Information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:
within on. business day after the receipt of materials. 0
68UNIVERSAL F'FFV -yPVz f0t)"534"? CUSTOMER
LOAD NUM:
This Delivery Ticket incorporates herein bv reference Buyer's previously executed Credit Application. if any, Seller's Standard
Terms and Conditions, Seller's Quotatioi my, and Seller's Order Confirmation (in ng limitations of warranties), as if fully�
set forth on this Delivery Ticket ("Agreen—..'). Seller will provide the Standard Term- ---I Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were delivered as indicated and further expressly agrees to
pay in accordance with the Agreement.
1 h / UhIVILhIN 1 / -#—UINUKE I h JtKUVUU I � / JU E Y AN11
Aggregate products are naturally occurring materials including limestone, dolomite, granite, volcanic rock, sand, crave], and other
0 4
siliccous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite, granite, volcanic rock, sand, gavel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Freshly mixed wet cement and/or fly ash can cause eye irritation, skin and eye bums and allergic skin reactions.
b-iTr-concr�ete�an��4-,--�-r—egateFdust--may--causejryjtat.tQrL-to_-eyes,-skin,andZou,e,spiratoly tract. Dust from handling,
crushin.-, grinding, cutting and/or drilling may contain silica—,NNilirchit�ay �caus�--Kil��--osi �a� f9riffale—ciz.
If ingested, keep warm, at rest, and drink large amounts of water. Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the, ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose. throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contact with skin. Wear gloves, eye protection, and appropriate protective
clothin-. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust, If exposed to
0
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact� immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit www,cemexusa.com.
Este ticket de entrega incluye como referencia al comprador (ya previamente ejecutada en su aplicaci6n de crddito)� cualquier
tdi-mino estAndar. condiciones del vendedor, propuestas del vendedor y orden de confin-naci6n del vendedor (con limitaciones y
garantfas). como acuerdo total del ticket de entrega ("Contrato"). El vendedor proveerd los t6rminos estdndares y condiciones detal-
lados en caso de asf set requeridos. Con este documento, el comprador acepta los mismos yaantes mencionados y que las cantidades
y materiales fueron entregados como se expresa en el rnismo. Acepta pagar el monto deacuerdo al contrato; al menos que se identi-
fique con una nota a] frente de este documento.
DE CONCRETO / CENIZAS
Los productos de agregados son materiales naturales como piedra caliza, dolornJta, granito, roca volednica, arena, grava y otros
materiales silicios. Los productos de cemento incluyen Cemento de tipo Portland, de albaNilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos de concreto incluyen cemento Portland y productos de agregados como piedra caliza, dolomita,
granito, roca volcdnica, arena, grava, y otros materiales silicios. Estos productos incluyen cenizas volantes (fly ash) ]a cual puede
contener mAs de 0.025% de silicio cristalino.
Peligros: Mezcla de cemento fresco y/o cenizas volantes pueden causar irritaci6n en los ojos, quemaduras en piel y ojos, y
reacciones al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritaci6n en los ojos, piel y/o en
la zona respiratoria. Polvo del marejo en el trituramiento, pulido, corte y/o perforaci6n puede contener materiales
silicos, los cuales pueden causar silicosis pulmonar y cAncer si son inhalados. En caso de sor ingeridos, mantenerse
en temperatura c6lida, reposar y tomar grandes cantidades de agua. Las cenizas volantes pueden contener amoninco.
La humedad puede causar la liberaci6n del an-loniaco. La inhalaci6n del amoniaco puede causar toser, irritaci6n o
Seguridad: queinadurasenlaiiariz,gargantaypulmones.AcudiriDmediatainentealniedico.Elriesa,oenlasaluddependeen
la duraci6n y el nivel de la exposici6n.
Seguridad: Evite el contacto con ojos y contacto prolongado con la piel. Use guantes, protecci6n en los ojos y ropa
Primeros adecuada para protecci6n. LAvese las manos conjab6n suave y agua despu6s del manejo de materiales. Evite inhalar
auxilios: polvos. Si se expone a polvos mds de Jos lintites recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en los ojos, inmediatamente fluya agua en ]a parte afectada por 15 minutos.
Si se inhala polvo. exp6ngase a aire fresco. Si el cemento fresco tiene contacto con sus ojos, lAvelos a fondo con
agua. Acuda a atenci6n m6dica inmediatamente si ]a irritaci6n continda.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mAs informaci6n visita www.ce
zzCC_MC_x
I
5 7 81-2 3 3 4 3
Plant:
Begin Loading:
To Ab:/
Arri�ii Job:
Start Unload:
Finish Unload:
LeaveJob:
11;�'' 'Jof I.,
Customer Code: Customer Name:
'.ProjectOode:� 'Pr0Tedtf!46e,_N
Ticket Date: Delivery Address:
:1 chelhve� fnsinucttb�s:
Customer Job Number:
Project P.O. Number
Order Code / Data:
F� 5'�jar P.O. NumbieP 1 i I
Q_Page: Map/Row/Column:
Due On Job: Slump: Truck Number. Driver Number: Driver Name: End Use:
LOAD
CUMIJ LATIVE
ORDERED
QUANTITY
QUANTITY
QUANTITY
MATERIAL CODE
PRO 6OCTION DESCRIPTION
UOM
I
NIT PRICE
I U
AMOUNT
yi
I fr-A WC11-VAPF.
Cash Check#/Auth Code: Signature f D�eer Receiving Gash: Cash Received! Torial COD Order Amount to Collect
Without Standby Charges:
Check
Charge or�
comments:
WATER ADDED: GAL YARDS IN DRUM -
WHEN ADDED.
SIGNATURE
CURB LINE CROSSED AT OWNER'S/AGENTS REQUESt:
rl "y j-� j" 7 T L '
SIGNATURE
!'r, PTI I y I_: 11_j i 01FID YARDS El LOAD WAS TESTED BY:
Notice: Our drivers will malte'every effort to place materials where the customer designates, but the SPECIALTERMS: Any water added is at customers own disk If water is added on job, concrete strength
Company assumes no responsibility for damages Inside curb or property line. Customer agrees to the is no longer guaranteed. WARNING: Product may cause skin andfor eye indication. CAUTION: Material
terms of aefl.,and delivery and accepts concrete as is. [)us to Important factors which am out of Our May be hazardous to your safety and health. Please refer to the backside of this ticket for important
control after delivery, this Company will not accept any responsibility for the finished results, No credit for safety handling mlomestion, and to the material safelty data sheets for additional information.
returned concrete. Buyers exceptions and claims shall be deemed waived unless made to us in writing AUTHORIZED SIGNATURE:
within one business day after the receipt of materials. (9)
I
68UNIVERSAL I I CIFID NJUM.'
CUSTOMER
This Delivery Ticket incorporates herein 1— eference Buyer's previously executed C—dit Application, if any, Seller's Standard.
k. Terms and Conditions, Seller's Quotatior my, and Seller's Order Confirmation (in ng limitations of warranties), as if fully
set forth on this Delivery Ticket ("Agreenivin'). Seller will provide the Standard Term� .— Conditions upon request. Buyer agrees
that, unless otherwise noted on the front hereof, all quantities and items were deljvered as indicated and fu�her expressly agrees to
pay in accordance with the Agreement.
AGGREGATE / CEMENT / CONCRETE PRODUCTS / FLY
Aggregate products are naturally occurring materials including limestone, dolornite,granitc, volcanic rock, sand, gravel, and other
siliceous materials. Cement products include Portland cement, masonry, pozzolan (Type IP), roof tile, and stucco. Concrete
products include Portland cement and aggregate products including limestone, dolomite. granite, volcanic rock, sand, gravel, and
other siliceous materials. These products, including fly ash, may contain more than 0.025% crystalline silica.
Hazards:----U.rg.sh"
--y ixed y�et cement and/or fly ash can cadse eye irritation, skin and eye burns and allergic skin reactions.
D nd1ggrcgate-dTst m—qy-cEFu-9i�-4rritation--.to-.e.y.esrskin.�,Lnd/or-respirato�-tract-DustjrojlI handling,
crushing, grinding, cutting and/or drilling may contain silica, whid�a� ca-use sillicUsis and cance—r if7inhaled—.
If ingested, keep warm, at rest, and drink large amounts of water, Fly Ash may contain trace amounts of ammo-
nia. Moisture can cause the ammonia to be released. Inhalation of ammonia can cause coughing and irritation
or burns of the nose. throat and lungs. See physician. Health risk depends on duration and level of exposure.
Safety: Avoid contact with eyes and prolonged contactwith skin. Wear gloves, eye protection, and appropriate protective
clothing. Wash hands thoroughly with mild soap and water after handling. Avoid breathing dust. If exposed to
dust above recommended limits (see MSDS), wear suitable NIOSH-approved respiratory protection.
First Aid: In case of eye contact, immediately flush eyes with flowing water for 15 minutes. If dust is inhaled, move to fresh
air. If wet cement contacts skin, rinse thoroughly with water. Get proper medical attention if irritation persists.
CEMEX, Memorial Hermann Tower
929 Gessner, Suite 1900
V7 combined Houston, Texas 77024
02/12 For more information please visit Nvww,cemexusa.co
F�tc ticketde-erwcg d -(ya-previamente ejecutada en su aplicaci6r) do cr6dito); cualquier
ga incluye corno re-ferencia- a[ compral
del;tdrmino estdndar, condiciones del vencedor. propuosiets endedor y orden de confirmaci6n del vendedor (con limitaciones y
garantlas), corno acuerdo total del ticket de, entrega ("Contratc "). El vendedor proveerd los t6rminos estAndares y condiciones detal-
lados en caso do as] ser requeridos. Con este documento, el compradoracepta los mismos yaantes mencionados y que las cantidades
y materiales fucron entregados como so expresa on el mismo. Acepta pagar el monto de acuerdo at contrato; at menos que so identi-
fique con una nota at frente de este documento.
/ UENIENYU /
DE
FILM-DIVI IF&K
Los productos; de agregados son materiales naturales como piedra caliza, dolomita, granito, roca volcdnica, arena, grava y otros
materiales silicios. Los productos do cemento incluyen Cenimo de tipo Portland, de albaffilerfa, pozzolan (tipo IP), azulejo de
azotea y estuco. Los productos do concreto incluyen cemento Portland y productos de agre.gados como piedra caliza, dolomita,
granito, roca vole6nica, arena, grava, y otros materiales sj!i( ios. Estes productos incluyen cenizas volantes (fly ash) la cual puede
contener mds de 0.025% de silicio cristalino.
Peligros: Mezela de cemento fresco y/o cenizas, olantes pueden causar irritaci6n en los ojos, quemaduras on piel y ojos, y
maccioves al6rgicas en la piel. Concreto seco y polvo de agregados, pueden causar irritacio'n en los ojos. piel y/o en
la zona respiratoria. Polvo del manejo en el trituramiento, pulido, corte y/o perforacidn puede contener matcriales
sili<- �, los cuales pueden causar silicosis pulmonar y cincer si son inhalados. En caso de set ingeridos, mantenerse
en"wimperatura cdlida,reposar y tomar grandes cantAades de agua. Las cenizas volantes pueden contener amoniaco.
h, guridall: La humedad.$p,-!ede causar la iiberaci6n del rmonjiSo. La'inhalaci6n del amoniaco puede causar toser, irritaci6n o
quemaduras �n ]a nariz, gal7ganta y pulinotfes. AcuAir inmediatamente at medico. El riesgo en la salud depende en
la duraci6n y el nivel, do la exposici6n.
Seguridad: Evite et contacto con ojos y contacto prolongado con la piel. Use guantes, proteccift en los ojos y ropa
Primeros adecuada para protecci6n. LAvese las manos conjab611 suave y agua despu6s del manejo de materiales. Evite inbalar
anxilios: polvos. Si so exponea polvos mds do los limites recomendados, use protecci6n respiratoria.
Primeros auxilios: En caso de contacto en Ins ojos, inmediatamente fluya agua en la parte afectada por 15 minutos.
Si se inhala polvo. exp6rigase a zii-c vresco. Si el cemento fresco tiene contacto con sus ojos, hivelos a fondo con
agua. Acuda a atenci6n raddic-'i imaediataniento si ]a irritaci6n continda.
CEMEX, Memorial Hermann Tower
929 Cessner, Suite 1900
V7 combinado Houston, Texas 77024
02/12 Para mds informaci6n visita www.ce